HN03�HEAD AND NECK SECOND PRIMARY TUMORS IN LARYNGEAL SCC ARE NOT ASSOCIATED WITH POORER OVERALL SURVIVAL: A SINGLE CENTER STUDY IN 987 PATIENTS

Objectives: Second Primary Tumours (SPTs) have been implicated in poor Overall Survival (OS) of Head and Neck Squamous Cell Carcinomas (HNSCCs). The incidence of SPTs; the SPT diagnostic time lag; the impact on OS; and the mean annual risk was assessed. Methods: 987 consecutive patients treated for primary larynx SCC (1967–2004) were analysed in this study. 96.3% and 91.4% of patients reached a minimum follow up period of 3 and 5 years. Results: 208 (21.1%) patients were diagnosed with SPTs. 143 (14.5%) patients developed upper aero-digestive tract UAD-SPTs, 83 (8.4%) were HNSCCs, 56 (5.7%) were lung, and 4 (0.41%) were oesophageal SPTs. Survival analysis demonstrated unexpected but clear superior OS rates for the UAD-SPT (p < 0.008) and HNSCC-SPTs (p < 0.001). Patients with synchronous SPTs had a poorer overall survival (p < 0.001). The mean annual risk of developing UAD-SPTs was 2.4%. Conclusion: These results suggest that HNSCC-SPT should not be viewed as an adverse prognostic factor. Reclassifications of UAD-SPTs into HNSCC-SPT and non HNSCC-SPT better reflects their clinical behaviour and prognosis.